HomeMy WebLinkAboutDrain Layers Permit 33 Eagle Run { 3
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7 Co 'Yacto WIL OXY''d CHAEL (EAGLE)
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Permit No. 7938 Town of South Windsor, CT
Permit Date 06/24/2005 " r3� Drain Layer Permit
Expiration Date 07/24/2005
Descrip: LOT 19 »�
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Name WILCOX MI HAEL ' `A IF �Addr. EAGLE EARTHWOR <SERV .:r W tz:MANNAR:: 3� BUILDERS INC
101 N MOUNTAIN:'RDP)� � $ + r
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CANTON
Phone No. 860 693- 02`7'
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The Drain L a er?>
Y c,�.�s�Y'i' <'ss�ued by the j
state and hereby agx s. CQ 17 the tq am cond��i s b :.;ff th in the
attached 'Condition5' .nAll' svcz )a sha .' r � fxif os?arace,rwkth iT,<bwn of South
Windsor standards, ay3;1 OHA:;fqujrej<< le a .tac:hel``abnditions.
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Date Inspected __- Inspected By __—_
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: S o 110 Lot # !9
Street No. Street Name
Premises owned by:
Name of Firm:-150 C, Phone: c Z
Address.of Firm; /0
TYPE OF WORK:
Lay.House Drain__�&—; Repair House Drain ;
Lay Main ; L.ay Lateral'for Commercial/Industrial
Building of acres
Connection will be made with _ 4
Existing Water Supply: Public Water ___ Well
Proposed Start DateL Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to,�1 oC 6v l /A/,P -OK the holder of Drain
Layer's License No. Only holders of P-1, P-7 or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30)`DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name:, C � ewl
Licensed Drain Layer
Date:_
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITA RY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET Pt�,Ly_ V-Q(V
-f- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER